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Dear East Bay Getting to Zero community,
    
Please see the weekly update on the
EBGTZ website and highlights below. Click here to download the PDF version. 

Join us on Thursday, February 25, 2021 11-12:30 PM for State of the Pandemic in Alameda County: COVID-19 Conversations on Vaccines, Variants, and More. There will be a presentation, conversation and ample time for live Q&A. Learn more about the current state of COVID-19 in Alameda County, the vaccine and roll-out, and strategies that will protect your patients, consumers, and community from the virus and misinformation.


Last week, the Black AIDS Institute released a video accompaniment to their report: We The People: A Black Strategy to End HIV. Check out the report and video here.


A survey for all health care workers: UCSF’s Center for AIDS Prevention Studies is calling all health care workers (broadly defined) for a 10-25-minute survey about their experiences during COVID-19. There is an optional $100 Amazon gift card raffle. The consent and survey can be accessed here.
 

East Bay COVID-19 Updates 

COVID-19 daily case and hospitalization rates have decreased over the past month but are still at high levels in the Bay Area. Death rates have begun to decline after record highs. Estimated transmission rates in the Bay Area have been below 1 (0.61 to 0.78), so cases are decreasing. Bay Area ICU capacity is up at 24% as of February 16.
 
We will need to continue to
wear masks, keep distance and get vaccinated as soon as we can, especially with more infectious variants identified in the Bay Area. The South African variant was reported on February 10 in Alameda and Santa Clara Counties. Please see below for more prevention tips. It’s a race against mutants! 

Vaccinations are available now for health care workers, nursing home residents and people over 65. Starting February 8 in Alameda County, a small group of essential workers in education/child care, emergency services and food/agriculture became eligible for vaccines under Phase 1b Tier 1. This week vaccine deliveries are delayed due to the winter storm and may require some sites to cancel appointments if they don’t have enough supply to last through the week.    

The Alameda County Fairgrounds mass vaccination site opened on February 15 (pictured here) and is focusing on vaccines for people ages 65 and older. The Fairgrounds site aims to administer 2,000 doses per day this week and will scale up to 5,000 doses per day when the county receives enough vaccine supplies. Click here to sign up for county vaccine invitations for this site. 
 
The
Oakland Coliseum mass vaccination site opened on February 16 to all eligible community members in the region! Click here for the MyTurn webpage to check eligibility and appointment availability. People ages 65 and older and some frontline workers (health care workers, educators, food/agriculture and emergency workers) are eligible. New appointment slots are added to many sites as vaccine supply comes in, so keep checking and sign up for notifications. Click here to watch a video from NBC Bay Area on what to expect at the Coliseum vaccination site. 

CVS pharmacies and Rite Aid pharmacies in the region are also now vaccinating healthcare workers and people 65 and older. 
 
Providers are encouraged to talk with patients and clients about vaccinations to combat misinformation and address concerns. Communities of color continue to turn to their trusted health providers for counsel, and
providers are changing minds about vaccinations. The ICD-10 code Z71.89 may be used for vaccine counseling done in medical provider visits. Dr. Sunny Lai from Highland’s HIV clinic compiled Guidance for talking with patients about vaccines and FAQs for PLWH (click to download the PDF).
 
People needing medical care for any condition are still encouraged to seek care as our clinics and hospitals remain open with strict safety protocols to take care of all people.

Community Spotlight on the COVID-19 Vaccine

Jesse Brooks, Community Activist says:
 
“Being vaccinated was important to me, I can't wait to get back to some resemblance of normalcy. I miss my family, and especially my 86-year-old mother.  The worst for me have been all the deaths, bringing up PSTD from the early years of HIV. It's been challenging living in daily fear of contracting COVID-19 or worse, passing it on to loved ones. As a community leader I felt the demonstration to the community and my family was important, knowing the mistrust that exists and knowing that it's a challenge to put those fears to rest. I also felt I was at increased risk because of my age and comorbidities of diabetes.”

More vaccine updates
 
As of February 17,
Alameda County, Contra Costa County, and Solano County are prioritizing vaccinations for health care workers, people in nursing homes and people over the age of 65. CA vaccine priority groups are defined here
 

Alameda County also opened eligibility to workers in education and child care, emergency services, and food/agriculture starting February 8 prioritized by exposure and disproportionate risk and are invited to appointments as vaccine supplies allow. Family care givers also now qualify for vaccines as health care workers in Alameda County as of February 5. Family care givers must provide an attestation letter that documents that they provide hands-on care for a person with a disabling condition that puts them at risk for severe COVID-19. An attestation letter template will be available on the Alameda County website.  
 
To access vaccines, we recommend the following steps:

  1. Sign up for all the notification systems available to you: see links below.
  2. Check on your vaccine eligibility with your medical provider and/or county for when the vaccine is available for your age or occupation group. See links below.
  3. When vaccine is available for your group:
    • If the notification systems work, you should get a link for appointments when vaccine is available for your group.
    • Check online or call your medical provider periodically for appointment availability.
    • If you cannot get a vaccine through your health provider, check if you can get a vaccine through a public (county) vaccination site.
    • Don’t give up! (Even though it sure can be frustrating and confusing.) Keep checking and trying; eventually there will be enough vaccine.
 
All COVID-19 vaccines should be available at no cost.
 
Notifications for when vaccine is available for you:
There is no unified notification system, so you may choose to sign up for many different notification systems to stay informed about the full breadth of vaccination opportunities available to you:
 
Vaccines through medical providers:
 
Vaccines for the public at mass vaccination sites (new!):
 
Vaccines through pharmacies (new!):
 
Vaccines for the public through county vaccination sites:

 
Vaccine appointments are still difficult to access due to limited and uneven vaccine supplies, a fragmented health care system, and a confusing eligibility system. For example, one medical provider may have enough supply to vaccinate people ages 65+ while another only has enough to vaccinate people ages 75+. In addition, while essential workers in education/child care, food/ag and emergency services are “eligible” in Alameda County, the county has an internal priority sequences to invite sub-groups of these essential workers based on exposure, age, uninsured status and zip codes at highest risk. The
Oakland Coliseum mass vaccination site will bring in thousands of more vaccines to the region and will hopefully streamline availability.
 
Who is eligible for vaccines now?
Bay Area counties are following
CA state guidelines on vaccine prioritization, which were updated on February 1:

Alameda County additionally uses the following criteria to determine whom to invite to make appointments at county vaccination sites through their notification system:

People living with HIV and COVID-19 vaccines

Currently all people living with HIV (PLWH) are recommended to get the COVID-19 vaccine once eligible. California state announced that starting March 15, “healthcare providers may use their clinical judgement to vaccinate individuals age 16-64 who are deemed to be at the very highest risk for morbidity and mortality from COVID-19 as a direct result of one or more of the severe health conditions included in this provider bulletin.” Advanced HIV was not listed as one of the severe health conditions, but providers can determine if “The individual is likely to develop severe life-threatening illness or death from COVID-19 infection.” There is emerging data that people living with HIV and CD4 counts less than 200 are at greater risk for hospitalizations and death. 
 
The
Moderna vaccine trial included 179 PLWH and the Pfizer trial included 196 PLWH but data on these sub-groups has not been reported separately yet. There is currently no recommendation to check antibody levels for people living with HIV after completing vaccination. We are not sure yet how much commercially available SARS-CoV2 antibody tests such as at Quest and LabCorp check for protective levels of neutralizing spike antibodies generated by the vaccines, but providers and patients may discuss checking for spike IgG antibody levels two or more weeks after the second vaccine dose while we await more data.
 
The CDC has updated their
quarantine guidance for people who are fully vaccinated and exposed to COVID-19 in community settings: “People who have been in close contact with someone who has COVID-19 are not required to quarantine if they have been fully vaccinated against the disease within the last three months and show no symptoms.”
 
Help the vaccine roll-out effort!

 
For more COVID-19 vaccine resources,
please click here.

Trends in cases, transmission rates and disparities
 
Transmission rates (Re) continue to be less than 1, which means cases are decreasing. As of February 15, the transmission rates were 0.78 in Alameda County, 0.77 in Contra Costa and 0.61 in Solano County, and 0.65 statewide. Our goal is to support the vaccine roll-out, masking, distancing, staying outdoors and avoiding gatherings to keep transmission rates less than 1.
 

Alameda County data as of February 17:

Contra Costa County data as of February 17: Solano County data as of February 17:

SF Chronicle, 2/17/21: COVID-19 daily cases and deaths in the Bay Area. 

Latinx and Black/African American Californians continue to be disproportionately impacted by COVID-19 as shown here as of February 17, 2021 in the CDPH CA State COVID-19 dashboard.

In Alameda County, while case rates are falling from their January peak, Latinx people are still more than 4 times more likely to be diagnosed with COVID-19 than white people. Black/African American residents are nearly 2 times more likely to die from COVID-19 compared to their white neighbors. 

Alameda County vaccination equity data shows that Latinx and Black health care workers are underrepresented among those who have received vaccinations. However, in early February a vaccination site at Fremont High School in East Oakland demonstrated in the graph above that allowing for walk-up vaccinations increased vaccination rates among Black and Latinx residents (see orange bars for vaccines by appointment and gray bars for vaccines by walk-up). The County will be advocating for more walk-up vaccination opportunities located in the hardest-hit neighborhoods. 

A recent opinion article by Ana Delgado, a nurse midwife and Assistant Director of Inpatient Obstetrics at SF General, describes the importance of tackling white supremacy in healthcare and embodying reproductive justice during the pandemic. 
 

A new CDC study shows that people who are LGBTQ+ have higher rates of health conditions associated with serious COVID-19 illness compared to people who are heterosexual. 

A modeling study investigating transmission rates (Rt) by age group found that people ages 20-49 are likely sustaining COVID-19 transmission throughout most of the US. The 20-49 age groups were the only ones with transmission rates above 1 through October 2020 (Rt= 1.3-1.4). Targeting prevention interventions, including vaccines, in these age groups is critical for getting this pandemic under control. 
 



Harm reduction tips and resources
 
A new mask study by the CDC demonstrates that tight-fitting multilayered masks and double-masking can decrease exposure to aerosols by up to 95%.
 

Harm reduction resources
 
Our summary of
COVID-19 harm reduction strategies is continuously updated with new studies. 
 
Free COVID-19 testing sites:
Click here for Alameda County, Contra Costa County and Solano County testing sites.

East Bay Opportunities: jobs, funding and events
 
Funding Opportunities:
 
The Alameda County Public Health Department Office of HIV Prevention has posted a
Request for Proposals for HIV prevention services in Alameda County. Bidders conferences will be held on February 18th and the deadline for required letters of intent is February 19 at 5pm. Please contact Steven Gibson at steven.gibson@acgov.org with any questions.
 
The California Department of Public Health Office of AIDS has released two requests for applications:  Strategic Rapid ART and Project Empowerment. Learn more about the opportunities
here.

Jobs, internships and other Opportunities:
 
Partnerships for Trauma Recovery is currently hiring for a Social Worker, an African Communities Counselor, and a Director of Client Care. The position descriptions can be viewed
here.
 
LifeLong Medical Care is looking for a HIV Case Manager at their East Oakland Health Center. The Case Manager will provide comprehensive individualized social services to people living with HIV (PLWH) in Alameda County. Learn more about the position
here.
 
Bay Area Regional Health Inequities Initiative (BARHII) is looking for a Communications Officer, an Administrative Specialist and an Interim Development Director. Learn more about the positions
here.
 
Alameda Health Consortium is looking for a Development and Communications Intern to assist their Grants/Development and Communications/Advocacy team with grants management, training, video production, data analysis, communications and list management related to our work with policymakers, funders, the media, and community engagement on behalf of our health centers. To apply, please submit a cover letter and a resume to be considered to:
mschoenberg@alamedahealthconsortium.org by 2/19/21.
 
The Center for Environmental Health is looking for a Community Health Cases Manager to work with community-led organizations and help manage and guide our community exposure litigation. Learn more about the position
here.
 


Alliance for Girls and Betti Ono Art Gallery have collaborated to create Radical Visions of Safety from Our Home to the Streets. It is an open call for art to any girl or gender expansive youth who would be interested in sharing their artistic vision of radical safety. Participants who submit their artwork will have the opportunity to win up to $1,000 for their submission. Artists can submit their artwork to the Radical Visions of Safety Open Call form. Artwork must be submitted by 11:59 on Feb 28, 2021. The open call website has more information on submission guidelines and recommendations.
Web-based Trainings, meetings and conferences:
 
Join PAETC for From Jail to Care: Connecting People to Hope During and After Incarceration on Tuesday, 2/23 at 12:15pm. Register
here.
 
The 2021 Biomedical HIV Prevention Summit is set to be held virtually on March 30-31.
Registration is open until March 19. Register here.
 
Bay Area Regional Health Inequities Initiative (BARHII) is hosting their general membership meeting on Friday 2/19 from 10-12pm. The meeting will be on the topic of “Anti-Black Racism and Housing in America: Where We've Been, What's Next.” Join the meeting via
this link (Event Password: JoinBARHII).
 
IAS-USA hosted a live webcast last week called “COVID-19 Meets HIV”: Variants, Vaccines, Health Disparities, and Other Fast-Evolving Issues?” Recording is now available on demand
here.
 
Region 9 Prevention through Active Community Engagement Program and partners will host “Stop HIV Together” a virtual Panel Discussion with Black American Community Leaders on Wednesday, February 24 from 11:00 am-12:15 pm. No registration is required. Join via
this link. (Meeting number (Access code): 1991459867; Meeting password: mPx4wC3JdJ3)
The EBGTZ website continues to have weekly updates on Wednesday evenings, and this newsletter will be sent out twice a month on 1st and 3rd Wednesdays. Please follow and share our Instagram, Facebook and Twitter accounts. 
 
Thank you for all that you do for our communities!
Sophy, Yamini and Sami
 
***
Sophy S. Wong, MD, Director
Yamini Oseguera-Bhatnagar, Program Manager
Sami Lubega, MD, Prevention Director

East Bay Getting to Zero

 
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